Analysis Of Risk Factors For Gastric Xanthelasma In Wuwei Cohort Population

ObjectiveThis study was based on a large-scale natural population study cohort established in Wuwei,an area with a high prevalence of gastric cancer in China.The purpose of this study was to investigate the epidemiological characteristics and related factors of GX in the cohort,and analyze the correlation between GX and gastric cancer and precancerous lesions,so as to provide theoretical basis for the diagnosis and treatment of GX.MethodsIn our study,a total of 5374 patients are enrolled in Wuwei natural cohort after screening by inclusion and exclusion criteria.There are 137 cases in the GX group and680 cases in the non-GX group.The general demographic data,clinical features,concomitant diseases and clinicopathologic features of the two groups are retrospectively analyzed,and the relationship between GX and the above factors are discussed and the related factors of GX are analyzed.The correlation factors of GX are screened by multivariate binary Logistic regression model,and the predictive model is constructed.The predictive value and efficiency of the model is evaluated by drawing the Receiver Operating Characteristic Curve（ROC）.Results1.Baseline feature:The detection rate of GX in Wuwei natural population cohort is 0.64%.Among the 137 GX patients,76 are males and 61 are females,with a male-to-female ratio of 1.25:1.The average age is 52（47,58）years old,and middle-aged patients aged 45-59 years old are in the majority.GX is more common in middle-aged and elderly people,with more males than females,and the difference is statistically significant（P<0.05）.The GX group and the non-GX group have statistical differences in education level,occupation,household annual income and BMI.In terms of daily diet habits,there are statistically significant differences between the two groups in the intake time of vegetables and fruits,preference for hot food and preference for fried food.In terms of combined history of related diseases,there is statistical significance between the GX group and the non-GX group with regard to previous history of gallbladder related diseases.56.2%cases in the GX group show slight drowsiness,and the difference is statistically significant.The infection rate of HP in GX group（72.1%）is especially higher than that in non-GX group（33.9%）,and the disparity is statistically significant.In the GX group,the patients with endoscopic concomitant lesions and the detection rate from high to low were chronic atrophic gastritis,gastric polyp,bile reflux and peptic ulcer.The most common pathology of GX patients are gastric cancer and precancerous lesions,and the difference was statistically significant.2.The related factors of GX:Single Logistic regression analysis shows that gender,age,BMI,household annual income,time of vegetable and fruit intake,occupation,hot food,fast food,fried food,HP infection,previous history of gallbladder,endoscopic polyps and drowsiness are correlated with the occurrence of GX.Multivariate Logistic regression analysis shows that age（OR=1.07,95%CI=1.038-1.104,P<0.01）and HP infection（OR=5.124,95%CI=3.246-8.087,P<0.01）are significantly correlated with GX,and are independent risk factors for GX.3.The clinical characteristics and related factors of GX in different forms:There are 97 cases of single GX and 40 cases of multiple GX.There are statistically significant differences in chronic atrophic gastritis and atrophy degree,intestinal metaplasia and intestinal metaplasia degree between the two groups.4.GX and chronic atrophic gastritis:There are 53 cases（38.7%）of chronic atrophic gastritis in the GX population.There are statistically significant differences in occupation,family income,systolic blood pressure,occurrence pattern,preference for hot food,fast eating and insomnia between the GX group with chronic atrophic gastritis and the group without chronic atrophic gastritis.In addition,there are statistically significant differences between the two groups in different degrees of atrophy,intestinal metaplasia and different degrees of intestinal metaplasia.5.GX and HP infection:¹⁴C urea breath test is used as the gold standard to confirm HP infection.There are 98 HP positive cases and 38 HP negative cases in the GX population.There are statistically significant differences in age and total annual family income between the two groups.Conclusions1.The detection rate of GX in Wuwei natural population cohort is 0.64%.Age,HP infection,annual household income of more than 20,000 yuan,consumption of vegetables and fruits for more than 1 month,combined history of gallbladder and endoscopic gastric polyps may be related factors for GX.The prediction model of GX is constructed by the above factors together,and the prediction efficiency of the model was statistically significant.2.The single form of GX is most common compared with multiple forms,and the form of GX may be influenced by chronic atrophic gastritis and intestinal metaplasia and their severity.3.Chronic atrophic gastritis and intestinal metaplasia are the most common precancerous lesions detected in the GX population of Wuwei natural cohort,implying that GX mucosa atrophy and intestinal metaplasia are at a higher risk,and GX may be one of the endoscopic markers of early gastric cancer and precancerous lesions.4.HP infection may be one of the independent risk factors for GX.